TIP OF THE WEEK

There are many factors that influence when a child reaches certain developmental milestones. Use this timeline to know what to expect in the first year.

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Q: My baby had a hearing test before she left the hospital, but now that she’s a few months old, I’m concerned she’s not hearing properly. What should I do?

A:

If you have any doubts about your baby or toddler’s hearing, talk to your doctor and get a thorough evaluation by a specialist as soon as possible. Hearing impairment can have a significant impact on your child’s development, and if there is a problem, you want to catch it early.

About one in every 300 babies is born with a hearing deficit, which can include total deafness. Diagnosing a hearing impairment in the first six months of life leads to earlier and more effective treatment; a later diagnosis can increase language and social problems, which decreases a child’s chances for successful preschool and primary school experiences.

We used to screen only higher-risk babies for hearing impairment—such as those with a family history of hearing loss—but now all medical groups, including the American Academy of Pediatrics and the American Academy of Family Physicians, recommend that every newborn be tested before being discharged from the hospital. The most accurate test is called the Auditory Brainstem Response, or ABR, which measures the way the brain responds to sounds.

However, research published in 2011 showed that nearly one-third of children who were diagnosed with major hearing loss requiring cochlear implants had passed their newborn hearing screen. The study concluded that even though the initial test is very accurate, about 30 percent of hearing loss and deafness may result from conditions that occur in areas of the ear or brain that are not evaluated by the test. Also, some types of hearing loss progress through childhood. What’s more, babies who passed the hearing screen were diagnosed with deafness nearly a year laterthan those who failed.

This certainly doesn’t mean we should abandon newborn screening, but it does underscore the fact that pediatricians and parents have to be vigilant through a child’s first years. We need to watch for delayed speech, very frequent ear infections, a family history of hearing loss, or diseases and medical conditions that can cause hearing problems, such as Down syndrome or very high levels of jaundice. Doctors also need to listen to the opinions of parents, caregivers and teachers when they suspect a problem.

So just to reiterate: If you think there may be a problem, be sure to act on it—and sooner, rather than later. I have rarely seen a parent who didn’t know when his or her child wasn’t hearing properly, and early diagnosis and treatment of hearing loss can make a big difference.